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Georgia rates for HCPCS B4199

Parenteral Nutrition Solution; Compounded Amino Acid And Carbohydrates With Electrolytes Trace Elements And Vitamins Including Preparation Any Strength Over 100 Grams Of Protein - Premix (Special Coverage Instructions Apply. See Cim: 65-10 And Mcm: 2130 4450)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$378.52 / $378.52 / $547.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$378.52 / $386.24 / $441.26
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$463.60 / $741.76 / $1,701.41
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$192.23 / $385.47 / $730.45
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$649.04 / $718.58 / $908.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$157.47 / $208.25 / $208.25
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.34 / $428.36 / $509.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$231.28 / $463.32 / $664.88